More black Americans say health outcomes for blacks in the United States have improved over the past 20 years than say outcomes have worsened, according to a 2021 Pew Research Center survey. Majorities of black adults also say their recent experiences with the healthcare system have been positive.
At the same time, however, black Americans have broad structural concerns about US health care and experience disparities in outcomes. For example, cancer and maternal mortality rates are higher among black Americans than among white Americans.
The Pew Research Center conducted this analysis to highlight the attitudes and experiences of black Americans regarding health care. We surveyed 14,497 American adults from November 30 to December 12, 2021, including 3,546 black adults (including those who identify as single-race, mixed-race, and black-Hispanic).
The survey was conducted by the Center’s American Trends Panel (ATP) and included an oversample of black and Hispanic adults from the Ipsos KnowledgePanel. Respondents in both panels are recruited through a national, random sample of residential addresses. That way, almost all adults in the US have a chance to choose. The survey is weighted to be representative of the adult US population by gender, race, ethnicity, party affiliation, education and other categories. Read more about the ATP methodology.
Here are the survey questions used for this analysis, along with the responses and its methodology.
This study was informed by a group of advisors with expertise related to the attitudes and experiences of Black and Hispanic Americans in science, health care, STEM education, and other fields. The Pew Research Center remains fully responsible for all aspects of the study, including any errors associated with its products and findings.
Here are five key facts about black Americans’ health care attitudes and experiences based on the Center’s 2021 survey:
Black Americans’ recent experiences with the US health care system have been mostly positive. About six in ten black adults (61%) say the care they most recently received was excellent (25%) or very good (36%), and another 25% say it was good. And about half (51%) say their out-of-pocket costs for that care were “about what’s fair.”
However, these views vary by income. About three-quarters of higher-income black adults (73%) describe their recent care as excellent or very good, compared with 66% of middle-income and 55% of lower-income adults. And 67 percent of higher-income black adults say their out-of-pocket costs for care are reasonable, compared to 46 percent of lower-income black adults.
Still, a majority of black adults (55%) say they have had at least one negative interaction with doctors or other health care providers. For example, four in ten say they had to speak up to get appropriate care, making it the most common type of negative interaction we asked about in our 2021 survey. About a third say their pain wasn’t taken seriously (35%) or that their provider rushed them (32%).
Black Americans’ responses to these questions did not differ dramatically from those of American adults in general. For example, 41% of all adults said they had to speak up to get proper care, and 32% said their pain was not taken seriously.
Among black Americans, younger women are the most likely to say they have had negative experiences with health care providers. For example, 52 percent of black women ages 18 to 49 say they had to speak up to get proper care. That compares to 40 percent of black women 50 and older, 36 percent of black men 50 and older, and 29 percent of black men 18 to 49.
Overall, 71 percent of black women ages 18 to 49 say they’ve had at least one negative interaction with a health care provider, compared to 54 percent of black women 50 and older, 51 percent of black men 50 and older, and 43% of black men ages 18 to 49. (Women were asked about a total of seven experiences, including one related to women’s health, while men were asked about six experiences. Age and gender differences remained when only the six trials requested by both males and females are analyzed.)
Younger black women are also the most likely to say they would prefer to see a black provider and that a black provider is better than other providers at looking after their interests and providing them with the highest quality care.
Black Americans cite a lack of access to high-quality health care as the main reason why blacks generally have worse health outcomes than other people. More than six in ten black adults (63%) say less access to care is a primary reason for these disparities, and another 22% say it is a secondary reason. Research shows that there tends to be fewer primary care physicians, trauma centers, pharmacies and COVID-19 vaccination centers near places where black Americans live.
About half or more of black adults also cite several other factors as primary reasons why black Americans experience poorer health outcomes. For example, 52% say the main reason is that blacks live in communities with more environmental problems, and 51% say the main reason is that black people are more likely to have pre-existing health problems.
Black adults with higher levels of education were more likely than those with lower levels of education to identify these and several other factors as primary causes.
Most black Americans say it doesn’t matter to them whether they see a black health care provider. More than six in ten (64%) say this. But 31% would prefer a black provider, including 14% who would strongly I prefer this. Only 4% would prefer no to see a black provider.
There were no large differences in these views based on whether black Americans had seen a black health care provider in the past. The share of black adults who preferred a black health care provider was similar among those who had previously seen one (32%) and those who had not (30%).
However, black providers are underrepresented in medicine, potentially making it difficult for those who prefer a black provider to find and book an appointment. Only 5% of physicians and surgeons nationwide are black, and the same is true of physician assistants. Overall, black Americans make up about 14% of the nation’s population.
Note: Here survey questions used for this analysisalong with the answers and his methodology.
Alec Tyson is associate director of research at the Pew Research Center.
Mark Hugo Lopez is director of research on race and ethnicity at the Pew Research Center.